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Is It Depression or Is It Just Depression?

Every week I go through at least one day that I feel depressed. Wen that happens, I always have to ask one question, “Am I suffering a depressive episode, or am I dealing with a typical day that I’m just feeling the blues? Is it just a normal depression that most people deal with now and again?” I was going through one of those episodes recently when I happened to have an appointment with my pdoc. I explained to him what I was going through and told him I was having some depressing days, and wasn’t sure if it was normal depression or did it feel exceptionally bad because I don’t have them as often as I use to. His one sentence response was, “Yes, that is the big question.” That was the best response he could give me?! That was no response at all. I left feeling more frustrated than when I arrived.

“Over the millennia scientists from many different disciplines have struggled with the issue of defining what is normal and what is abnormal or pathological with respect to human bodily or mental states and human behavior,” Klaus Scherer and Marc Mehu of the Swiss Center of Affective Sciences commented. They added:

Psychiatrists and clinical psychologists are often called upon to reliably distinguish between normal and abnormal emotions. Increasingly this is done with the help of diagnostic category systems developed by professional associations and health organizations like the Diagnostic and Statistical Manual for Mental Disorders (DSM). In consequence, the definition of abnormal emotionality proposed by these classification systems has an extraordinary impact on the diagnosis and treatment of what is perceived as emotional disorders or disturbances.

The DSM- 5 (The current issue of the DSM) specifies that the clinician should exert judgment when diagnosing depression after bereavement, but the continuum between what emotional state is normal and what is abnormal makes the process difficult, especially in the absence of agreed upon criteria.

I don’t know about you, but none of this gives me the answer I want. All this psychological mumbo jumbo seems to ask a lot of questions, with little or no answers. My pdoc refuses to give me anything that may lift my spirits. He did increase the dosage of one of my anti-depressants, but to me, I need just a little more of a lift, but he refuses. As I’ve said in a previous post, he’s concerned about giving me more because on one office visit I was clearly in a manic state. He’s never forgotten that day, but it seems like he has amnesia for all the days that I’ve been depressed.

In the end, I guess it’s up to me. Not that I can change the medications I’m on. It’s up to me to ride the storm. Don’t become hopeless when I’m feeling depressed. Instead, accept it’s only temporary. Whether it’s a short episode or a long one, I have to focus on the fact that it always goes away. Learning to ride it out is difficult. It took me a long time for it to be instinctive, but I believe I’ve learned to do it in most instances. It was worth the effort to learn.

Thanks for saying what we all have felt. My meds are working pretty darn well right now, since adding Abilify, but I still have down days. My husband says they don’t last as long, though. I have sort of the other problem: When I feel good, I’m never sure if it’s real or hypomania.

I had to just come up with my own criteria for “normal” emotions and those influenced by wonky brain chemistry. In my book if it’s causing dysfunctional thinking – perseveration, especially about past events that have nothing to do with the present, paranoia, agitation, and for me fighting with someone over and over and over in my head – then it’s not “normal.” Regular people don’t experience sadness that way, except in the most extreme circumstances. If it’s effecting my sleep or eating – beyond one evening or beyond one carby meal or snack which is a pretty normal reaction to a crappy day – it’s not “normal.” If I’m making bazaar predictions, especially negative or scary ones, about others’ responses or behavior then it’s not “normal.” (i.e. “So and so will be PISSED at me; this is going to cost our friendship” when in fact so and so has never demonstrated being pissed off at anyone in the past.) If the mood feels like it’s going to swallow me up, like it’s never going to go away, like I’ve felt this way forever and I’ve never felt good, then it’s not “normal.” On the other hand if something lousy is going on that would make many people bummed out, stressed, really sad, etc. then I’m just sharing in the panoply of human experience, which sometimes just sucks. But if it’s just normal sorrow then the things regular people do to cheer themselves up – talk to a friend, go for a walk, writing, enjoy wallowing for a day, eat some chocolate, plan something fun, watch and old favorite movie – should help. If they don’t, that’s another good hint that it’s not “normal.”

Sounds like you got a good handle on it, overall. I think I could learn from the way you assess your situations, rather than allowing myself to just being a victim regardless of where my state may be coming from.